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Anal fissure

MedGen UID:
42031
Concept ID:
C0016167
Acquired Abnormality; Disease or Syndrome
Synonyms: Anal Fissure; Fissure in Ano; Fissure, Anal
SNOMED CT: Fissure in ano (30037006); Anal fissure (30037006); Nontraumatic tear of anus (30037006)
 
HPO: HP:0012390

Definition

A small tear in the thin, moist tissue (mucosa) that lines the anus. It appears as a crack or slit in the mucous membrane of the anus. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAnal fissure

Conditions with this feature

Granulomatous disease, chronic, autosomal recessive, 5
MedGen UID:
1710326
Concept ID:
C5394542
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.

Professional guidelines

PubMed

Balla A, Saraceno F, Shalaby M, Gallo G, Di Saverio S, De Nardi P, Perinotti R, Sileri P; Anal Fissure Collaborative Group
Updates Surg 2023 Dec;75(8):2279-2290. Epub 2023 Oct 8 doi: 10.1007/s13304-023-01661-x. PMID: 37805973
Mathur N, Qureshi W
Curr Opin Gastroenterol 2020 Jan;36(1):19-24. doi: 10.1097/MOG.0000000000000599. PMID: 31688336
Guttenplan M
Curr Gastroenterol Rep 2017 Jul;19(7):30. doi: 10.1007/s11894-017-0574-9. PMID: 28567655

Recent clinical studies

Etiology

Balla A, Saraceno F, Shalaby M, Gallo G, Di Saverio S, De Nardi P, Perinotti R, Sileri P; Anal Fissure Collaborative Group
Updates Surg 2023 Dec;75(8):2279-2290. Epub 2023 Oct 8 doi: 10.1007/s13304-023-01661-x. PMID: 37805973
Nelson RL
BMJ Clin Evid 2014 Nov 12;2014 PMID: 25391392Free PMC Article
Nelson RL, Thomas K, Morgan J, Jones A
Cochrane Database Syst Rev 2012 Feb 15;2012(2):CD003431. doi: 10.1002/14651858.CD003431.pub3. PMID: 22336789Free PMC Article
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article
Jonas M, Scholefield JH
Gastroenterol Clin North Am 2001 Mar;30(1):167-81. doi: 10.1016/s0889-8553(05)70172-2. PMID: 11394029

Diagnosis

Drezdzon MK, Peterson CY
Surg Clin North Am 2023 Dec;103(6):1153-1170. Epub 2023 Jul 21 doi: 10.1016/j.suc.2023.05.014. PMID: 37838461
Balla A, Saraceno F, Shalaby M, Gallo G, Di Saverio S, De Nardi P, Perinotti R, Sileri P; Anal Fissure Collaborative Group
Updates Surg 2023 Dec;75(8):2279-2290. Epub 2023 Oct 8 doi: 10.1007/s13304-023-01661-x. PMID: 37805973
Steinhagen E
Dis Colon Rectum 2018 Mar;61(3):293-297. doi: 10.1097/DCR.0000000000001042. PMID: 29420424
Lohsiriwat V
World J Gastroenterol 2016 Jul 14;22(26):5867-78. doi: 10.3748/wjg.v22.i26.5867. PMID: 27468181Free PMC Article
Klein JW
Med Clin North Am 2014 May;98(3):609-23. Epub 2014 Mar 21 doi: 10.1016/j.mcna.2014.01.011. PMID: 24758964

Therapy

Balla A, Saraceno F, Shalaby M, Gallo G, Di Saverio S, De Nardi P, Perinotti R, Sileri P; Anal Fissure Collaborative Group
Updates Surg 2023 Dec;75(8):2279-2290. Epub 2023 Oct 8 doi: 10.1007/s13304-023-01661-x. PMID: 37805973
Patkova B, Wester T
Eur J Pediatr Surg 2020 Oct;30(5):391-394. Epub 2020 Sep 13 doi: 10.1055/s-0040-1716723. PMID: 32920798
Nelson RL, Thomas K, Morgan J, Jones A
Cochrane Database Syst Rev 2012 Feb 15;2012(2):CD003431. doi: 10.1002/14651858.CD003431.pub3. PMID: 22336789Free PMC Article
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article
Herzig DO, Lu KC
Surg Clin North Am 2010 Feb;90(1):33-44, Table of Contents. doi: 10.1016/j.suc.2009.09.002. PMID: 20109631

Prognosis

Adams ED, Mirocha JM, Fleshner PR, Zaghiyan KN
Dis Colon Rectum 2023 May 1;66(5):716-722. Epub 2023 Jan 24 doi: 10.1097/DCR.0000000000002700. PMID: 36716394
Sacks OA, Beresneva O
Dis Colon Rectum 2023 Jan 1;66(1):10-13. Epub 2022 Oct 27 doi: 10.1097/DCR.0000000000002661. PMID: 36515511
Balcı S, Onur MR, Karaosmanoğlu AD, Karçaaltıncaba M, Akata D, Konan A, Özmen MN
Diagn Interv Radiol 2019 Jan;25(1):21-27. doi: 10.5152/dir.2018.17499. PMID: 30582572Free PMC Article
Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S, Grande M
Minerva Gastroenterol Dietol 2017 Mar;63(1):44-49. Epub 2016 Oct 21 doi: 10.23736/S1121-421X.16.02343-6. PMID: 27768009
Schouten WR, Briel JW, Auwerda JJ, Boerma MO
Scand J Gastroenterol Suppl 1996;218:78-81. doi: 10.3109/00365529609094734. PMID: 8865454

Clinical prediction guides

Ebrahimibagha H, Zeinalpour A
Wound Repair Regen 2023 Sep-Oct;31(5):655-662. Epub 2023 Jul 8 doi: 10.1111/wrr.13103. PMID: 37340514
Adams ED, Mirocha JM, Fleshner PR, Zaghiyan KN
Dis Colon Rectum 2023 May 1;66(5):716-722. Epub 2023 Jan 24 doi: 10.1097/DCR.0000000000002700. PMID: 36716394
Chen Z, Pan S, Zuo S
Front Public Health 2022;10:1000338. Epub 2022 Nov 3 doi: 10.3389/fpubh.2022.1000338. PMID: 36407987Free PMC Article
Jin JZ, Bhat S, Park B, Hardy MO, Unasa H, Mauiliu-Wallis M, Hill AG
Surgery 2022 Jul;172(1):41-52. Epub 2022 Jan 5 doi: 10.1016/j.surg.2021.11.030. PMID: 34998619
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article

Recent systematic reviews

Jin JZ, Bhat S, Park B, Hardy MO, Unasa H, Mauiliu-Wallis M, Hill AG
Surgery 2022 Jul;172(1):41-52. Epub 2022 Jan 5 doi: 10.1016/j.surg.2021.11.030. PMID: 34998619
Nelson RL, Manuel D, Gumienny C, Spencer B, Patel K, Schmitt K, Castillo D, Bravo A, Yeboah-Sampong A
Tech Coloproctol 2017 Aug;21(8):605-625. Epub 2017 Aug 9 doi: 10.1007/s10151-017-1664-2. PMID: 28795245
Nelson RL
BMJ Clin Evid 2014 Nov 12;2014 PMID: 25391392Free PMC Article
Nelson RL, Thomas K, Morgan J, Jones A
Cochrane Database Syst Rev 2012 Feb 15;2012(2):CD003431. doi: 10.1002/14651858.CD003431.pub3. PMID: 22336789Free PMC Article
Nelson R
BMJ Clin Evid 2010 Mar 24;2010 PMID: 21718564Free PMC Article

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